BM mesenchymal stromal cells (BM-MSCs
IntroductionThe BM microenvironment plays a crucial role in multiple myeloma (MM) pathogenesis by supporting plasma cell growth, survival, and drug resistance, which has been partially attributed to the ability of MM BM mesenchymal stromal cells (BM-MSCs) to secrete growth factors and cytokines such as IL-6, IGF-1, VEGF, and many others (1-3). These observations are indicative of paracrine growth circuits between BM-MSCs and clonal plasma cells and vice versa, which suggests that the BM niche provides an optimal substrate for MM cell localization and growth. Nevertheless, little is known about the putative mechanisms by which the BM microenvironment can lead to initiation or progression of oncogenesis in this disease.It was recently reported that cell-cell communication is mediated by exosomes. Exosomes are small nanometer-sized (50-100 nm) vesicles of endocytic origin that are released in the extracellular milieu by several cell types (4-11) under physiological and pathological conditions, including antigen presentation, transmission of infectious agents, and tumors (12, 13). The role of exosomes in tumor progression is due to the ability of tumor cell-derived exosomes to modulate and mold the host microenvironment, thereby promoting tumor cell growth and disease progression (14-17).